Transcript Exercise Physiology

Brain-Based Learning Is the Foundation of
Integrated Curricula
C. Murray Ardies
The purpose of this presentation is to illustrate some of the basic concepts of brain-based
learning and how they can be incorporated into an integrated curriculum.
Brain-based learning is the process used to accomplish the educational objectives
of the curriculum:
An example curriculum for Health Science will be used to illustrate the concept.
The Health Science Curriculum is, of course, a sub-set of the Health Education
curriculum, which in turn, is a subset of the degree curriculum.
Some Basic Definitions
For the purposes of this presentation, the following definitions will be used (please note that they have been
derived from a variety of resources and only represent this author’s interpretation of what a consensus
definition might be):
Brain-Based Learning (BBL): an approach to instruction that is based on the neurological processes that occur
in the brain that in turn, result in the formation of new memories. BBL is often related to in-class activities but
addresses curriculum as well, in that course content is organized around “broad themes” (rather than specific
facts) and the factual content is taken from all of the different academic areas that apply to the themes. For our
purposes, BBL applies to in-class dynamics.
Integrated Curriculum (IC, aka Interdisciplinary Curriculum or Synergistic Teaching…): an approach to
developing entire curricula where concepts that overlap multiple disciplines are examined for common concepts
and the factual & conceptual interrelationships are highlighted.
some crude examples of IC: mathematics/physics… ecology/biology… literature/science…
geography/history… art/literature/language arts…
and of course… what could be called the health sciences:
(biology/biochemistry/nutrition/drugs/sexuality/exercise/disease…)
Problem-Based Learning (PBL; aka inquiry-based learning): An approach to integrated
learning based on student-initiated learning with guidance provided by an instructor/facilitator.
A series of realistic problems are “posed” by the instructor and students figure them out with
appropriate levels of guidance. The degree of guidance is decreased as students gain more expertise; often
starting with illustrated answers for initial problems. PBL is a dominant form of integrated
education within many medical schools world-wide and has been implemented as a component
of the curricula of many high-schools (Northside College Prep in Chicago, IL and Palo Alto
High in Palo Alto, CA for example – two of the highest-ranked high schools in the USA).
PBL / student-directed study without close guidance by an expert would not be appropriate for a
small child with very limited experience & knowledge (or a naïve adult; meaning: an adult without
the relevant experience and preliminary knowledge)… on the other hand, it should be relatively
easy for an expert…
While PBL is not a focus of this presentation, the basic concept of PBL, i.e.: first determine
all factual & conceptual areas and their inter-relationships necessary to address the
problem, then “have at it…”, is. A PBL approach to designing lesson-plans, course materials,
and curriculum development actually fits the BBL model very nicely so keeping this general
concept in mind simply makes it easier to conceptualize how to approach any integrated
topic…
Concept Map: A graphical approach used to illustrate relationships between concepts both
within and between disciplines. Concept maps are extremely useful in developing approaches
to problem solving within PBL. They also can be extremely helpful for students’ understanding
new learning in relation to what they already know, for educators to develop lesson plans, and
for educators in organizing and evaluating entire curricula.
For the purposes of this presentation concept maps will be used to illustrate the organization
of a (hypothetical) Health-Science curriculum which could be embedded within a larger Health
Education Major within an Education Degree.
…
A few different versions of a concept map…
In developing a Health Science Curriculum a PBL approach with appropriate concept maps helps
to organize things in a meaningful way… i.e. what are all those things that affect our health?...
And how do they work together to produce “health”?...
Specific areas of content are identified and added within each general sphere and
interrelationships are highlighted as the model is developed…
- We’ll deal with curriculum design later… First we’ll deal with experts and how they got that way…
you can imagine that things can get extremely complicated very quickly… and knowing
how it ALL fits together takes a pretty high degree of expertise…
From a couple slides ago… the concept of expertise vs. naiveté was raised… this is
very important because it brings us to the whole point of education:
…education systems (public schools, colleges, universities, etc.) provide
structured learning opportunities in order for students to develop a minimal
degree of functional expertise in a variety of areas deemed important by society.
From a curriculum standpoint the specific areas of minimal functional expertise are
defined by educational standards; for public schools in Illinois, the Illinois Learning
Standards1 (and their performance descriptors) describe what a student should know
and what they should be able to do, in all subject areas and at the different grade levels. (as
students progress through an educational system they gain more and more
expertise within the areas of study of study as defined by the standards.)
Please note: from science goal 12: “… provides fundamental concepts, principles, and interconnections of life,
physical, and earth/space sciences”,
from science goal 13: “… know and comprehend the relationships between science, technology, and
society…”1.
obviously these are Integrated Learning concepts!
So… What is an Expert? Why are they Important?
Experts are Learned People
Experts notice features and meaningful patterns of information
Experts have a great deal of content knowledge that is organized
Experts’ knowledge cannot be reduced to sets of isolated facts
- the knowledge is “conditionalized” on a set of circumstances.
Experts retrieve important aspects of their knowledge with little effort.
(My personal favorite): Though experts may know their disciplines thoroughly, this does not
guarantee that they are able to teach others.
Notice that the concepts of organization, patterns, and conditionalized knowledge are integral to
expertise. These concepts are fundamental to both integrated learning and the neurological
basis of learning.
Experts are Learned People…
But they Are Very Tough To Find!
Experts are important, especially when it comes to developing & teaching components of an
integrated curricula. Teachers need to have a high degree of expertise because without being an
expert it would simply be impossible to provide sufficient guidance for learning the integrated
concepts.
And to stray from the main topic a bit: An expert in math is not necessarily an expert in physics
or chemistry or biology and may not have the ability to integrate their knowledge of math into
the other realms of study. They would, however, have a much easier time “getting trained” to work within an
integrated math-science curriculum than someone without any expertise in mathematics.
While this concept will not be a major topic here, it does illustrate the difficulty in trying to
institute ANY integrated curricula, anywhere: our traditional education system, and especially
those that certify school teachers, are simply not designed to produce anyone with a high level of
integrated expertise.
- Hence the importance of professional development for teachers!
So… lets move on to the biological basis of learning…
To understand how expertise is developed we have to understand the
neurological basis of how the brain develops long-term (declarative) memories
that are easy to recall…
We can then use this knowledge to develop appropriate classroom activities that
can enhance learning in the classroom
We all have a central component to our nervous system called a brain and spinal cord
(CNS) and a peripheral nervous system (PNS) which includes a lot of sensory and motor
nerves.
The peripheral nervous system is responsible for communication between our brain (both
our “unconscious self ” and our “conscious self ”) and with the external environment as well
as with all parts of the body . . .
The brain coordinates and integrates information
from the internal and external environment …
Based on all of the internal sensory information received it selects the appropriate responses in
order to keep us alive (mostly subconscious) …
Based on all the external information received it selects and coordinates the appropriate behavioral
responses (both conscious and subconscious) …
The brain develops memories and maintains consciousness in order to more efficiently select
those proper responses that keep us alive, i.e.:
New stimulus Q: tried response 1, 2, 3, 4, & 5… I remember that response #4 was
the best so next time stimulus Q happens, will use response #4.
We pay attention to those environmental stimuli
that are the strongest…
…and react accordingly for “survival”
We also pay attention to those stimuli that are
most important to us…
…and react because we choose to
Based on all the external information received, and influenced by those stimuli that we
are most attentive to, the brain selects and coordinates the appropriate (or
inappropriate?) responses …
Some Important Parts of the Brain That Relate to Learning
Limbic (another very important) System of the Brain
The limbic system is
responsible for generating
our emotional feelings (pleasure, frustration,
anger) based on our cognitive interpretation of
our environment
Basal Ganglia – (Involved in Regulation of Movement)
is part of the limbic system
Putamem
Globus Pallidus
Caudate
Substantia
nigra
Ventral tegmental
area
Locus coeruleus
Memory, Learning & Behavior
The most basic connection between behavior and memory is that we desire to perform
behaviors which produce responses that we want….if we can’t remember that a particular
behavior resulted in a desirable outcome, there is little chance we will seek out to repeat the
same behavior.
In addition, if a particular behavior results in an unpleasant experience, there is a strong
likelihood that we will avoid that behavior.
On the other hand, if a behavior is not particularly pleasant, but will eventually result in a
highly desirable outcome, there is a high likelihood that the unpleasant behavior will be
continued in order to get the pleasant payoff.
So … How Does Memory “Work”?
A “memory” is not a discrete location in the brain made up of a cluster of cells which are
independent of other cells.
A “memory” is actually comprised of a “pattern” of nerve-cell activities made up of
interconnected nerve cells which are scattered throughout the cerebral cortex. These cells
are in turn interconnected to all other brain cells.
Memory/Learning
We do not remember facts as discrete pieces of independent information.
We have memories of “facts” only in association with other memories.
We develop new memories only in association with existing memories.
Memory/Learning
New memories are created by coordinating an existing pattern (or patterns) of activated nerve
cells that correspond to an existing memory (or memories) with the development of an
additional new pattern (or patterns) of activity.
This process demands synthesis of new proteins in “some” nerve cells to modify their ability
to be activated by other nerves and thereby create a new patterns of activation.
Learning
Parts of the brain
that are important
for learning.
Learning
Hippocampus coordinates and integrates all
incoming environmental stimuli with existing
memories that correspond to the stimuli so
we can identify (threats?) and act
accordingly;
activating ALL of them
– we then pay attention to those that we recognize
and are “important” to us
Learning
New memory is constructed
based on novel stimulus in
comparison to existing
memory.
“Strength” of the memory is
dependent on the frequency
and strength of the neural
activity.
How Does this Work?
The learning process demands synaptic
remodeling: the development of “new active”
synapses between existing nerves in order to
produce the new patterns of neural activity.
In order to do this a host of proteins that
stimulate nerve-growth must be produced and
maintained for many hours:
New Proteins: (synapsin I, synaptotagmin, syntaxin,
and integrins, among others);
Activate enzymes of the signal transduction
pathways: (Ca2+/calmodulin-dependent protein kinase
II, CaM-KII; mitogen-activated/extracellular signalregulated protein kinase, MAP-K/ERK I and II;
protein kinase C, PKC-δ);
Activate DNA-binding proteins (transcription
regulators): (cyclic AMP response element binding
protein - CREB, Brain-derived neurotrophic factor BDNF)
Inactive
Synapse
Synapse
Synaptic Remodeling
Active
Synapse
How Does this Work?
After sufficient amounts of new growth
signals have been produced …
&
… they remain elevated long enough in the
“stimulus-memory specific” activated nerve
pathways:
… a new memory is formed
Learning & Memory
The new memory can now be activated
either through the “novel” stimulus or
through the associated memory.
We remember facts as pieces of “information” in
relation to other pieces of “information” which
in turn are related to other …
Learning & Memory
Because we construct and remember
“facts” in relation to other “facts” that in
turn are related to other “facts” …
The greater the number of interconnected
pathways that “intersect” the “new memory” –
the easier it is to recall the “new memory”
Memory & Motor Skills
Sensory memories of
physical movements are
stored as patterns of neural
activity in the
cerebellum and are developed
in essentially the same way as
declarative (factual)
memories.
Skills & Memory
Analyze and activate memories of the array
of possible motor responses to the current
environmental stimuli.
Select appropriate motor response and
activate the pre-motor cortex to initiate the
selected movement patterns via the motor
cortex.
Basal ganglia (esp. caudate nucleus and
substantia nigra) help initiate & coordinate
activation of the appropriate motor neurons.
All sensory inputs are coordinated by reticular formation and basal ganglia and transmitted to frontal
cortex - Sensory input is unconsciously compared to sensory memory of the “selected” skill and
unconscious adjustments are made “on-the-fly”
Conscious images of movements are compared to conscious memories of what we think we should
look like while we do it and we make conscious adjustments to mimic the conscious memory “onthe-fly”
Integration of conscious and subconscious adjustments based on “on-the-fly” adjustments to
conscious and subconscious memories of the skill result in the actual performance
So… why is the skill stuff here?
Skills such as running & cycling (and a whole lot more) are actually just
programmed memories that are activated by a variety of stimuli; such as:
got to catch the bus…
starters pistol goes off at the beginning of a race…
PE teacher tells you to run for a standardized test… and so on.
Physical exercise is important for learning as illustrated in the following slides…
Add in the Exercise Concept to Learning and Memory:
- Rats with running wheels for 3, 7, & 28 days (my interpretation of the data):
Largest “transient” increase in processes associated with the growth of new synapses (synapsin I,
synaptotagmin and syntaxin; Ca2+/calmodulin-dependent protein kinase II, CaM-KII; MAPK/ERK I and II; PKC-δ; cyclic AMP response element binding protein, CREB)
Moderate “transient-longer” increase in brain-derived neurotrophic factor (BDNF)
Moderate “transient” increase in genes involved with associated excitatory effects (N-methyl-daspartate receptor, NMDAR-2A and NMDAR-2B and 1, EAAC1)
Moderate “transient” down regulation of genes involved with inhibitory effects (GABAA receptor,
glutamate decarboxylase GAD65).
Exercise can enhance learning by “priming the pump” for new growth
Exercise can enhance learning by “enhancing ABILITY to focus”
More Exercise Experiments Stuff:
Can activation alone produce brain changes without the subjects actually learning anything, just as
activation of muscles by exercise can cause them to grow?
4 groups of rats, treatment over 1 month:
1 was taught to traverse an elevated obstacle course (very little total activity)
2 “mandatory exercisers” ran 30 minutes, rested 10 minutes, then ran 30 minutes.
3 “voluntary exercisers” had free access to an activity wheel, which they used often
4 (control) “cage potato” rats
Results:
Mandatory exercisers and the voluntary exercisers had higher densities of blood
vessels than the cage potatoes or the “acrobats”
The “acrobats” had the greatest number of synapses/cell
Learning adds synapses; exercise does not!
Different kinds of experience condition the brain in different ways. Synapse formation and blood
vessel formation (vascularization) are two important forms of brain adaptation, but they are driven
by different physiological mechanisms and by different behavioral events
Learning specific tasks produces localized changes in the areas of the brain appropriate to the
task.
When young adult rats were taught a maze – a highly visual task, structural changes occurred in
the visual area of the cerebral cortex as expected
When they learned the maze with one eye blocked only the brain regions connected to the open
eye were altered.
When they learned a set of complex motor skills, structural changes occurred in the motor
region of the cerebral cortex and in the cerebellum.
Learning imposes new patterns of organization on the brain in ONLY those areas
that are specifically activated during the new learning activity
There is NO SUCH THING as “cross-learning”
(a play on the cross-training concept)
One Last Thing:
Where There is No Order - The Brain Imposes Order
In another experiment, people were given this list of words to memorize: sour candy-sugar-bittergood-taste-tooth-nice-honey-soda-chocolate-heart-cake-tart-pie.
During a test on whether a particular word was on the list, subjects insisted that the word “sweet”
was on the list.
People “remember” words that didn’t exist; the “brain” creates categories for processing
information.
Memory processes make relational links to other learned information – but just because you remember “it” doesn’t
mean “it” exists…
What does this Mean For Education?
Learning is an active process on the part of the student, NOT the teacher!
Educators cannot teach!
Teachers must create a learning environment to
help our students learn
Brain-Based Education
Memories are linked together in meaningful patterns – If no pattern exists one will be constructed:
Educators must explain thoroughly and illustrate exactly where the new learning fits
within the overall area of study and how this relates to other areas of study (teachers
MUST be experts) …
In other words, we must constantly integrate the “new learning” with the “established
learning” … (AND understand where this fits into “future learning)... Otherwise the
students will impose their own “order”; right OR wrong!
- topic concept maps
- course concept maps
- curriculum concept maps
Brain-Based Education
Memories are linked together in meaningful
patterns that are specific to the actual
“learning stimulus”
The more direct links there are to established learning…
the easier it will be to learn and remember …
Learning in one context will not automatically “cross-over” to another one …
memories:
few connections
memories:
many connections
Brain-Based Education
Repetition is key to forming new memories:
Without constant review new connections will NOT be synthesized and the
new learning cannot take place
Brain-Based Education
“Strength” of the memory is dependent on the frequency and “strength” of
the neural activity during learning.
“Strength” of neural activity is directly proportional to the degree of arousal
AND focus (engagement)… any distractions (such as tv/radio/ipod) severely
reduce the efficiency of the learning process: you simply cannot pay attention to
2 things at once!!
Brain-Based Education
It takes time to develop permanent memories:
Educators must adapt their teaching procedures
to allow time for memories to start forming
before moving on …
You can’t just plow through the lesson plans, you must explain thoroughly the facts,
relationships, and the integrated concepts … REPEATEDLY!
Educators cannot expect students to remember what was said 10 minutes or even 3
minutes ago …
Brain-Based Education
(It takes time to develop permanent memories)
Think sports … how much effort and time does it really take to become
minimally skilled …
Educators must recognize the tremendous amount of time and effort it really takes to
learn “well” … and incorporate that time into class AND DEMAND sufficient
homework to force the necessary practice…
Brain-Based Education
We must re-think how our entire education system is organized …
Traditional Model
Integrated Model
PBL Curriculum Development:
The purpose of the next set of slides is to illustrate how to approach the development of a
curriculum in Health Science... (not actually describe all the details of the courses in one....)
PBL Curriculum Development... start with the problem:
What Do You Have To Know and Understand to be an Expert in Health Science?
What are all those things that affect our health?... What inside of us gets affected by all those
things?... How does that change our health?... How does that change us?
How do all those things work?... How do they affect each other?... How can we change those
effects?... How can we make good things happen and bad things not happen?...
As specific areas of content are identified and interrelationships understood... The concept for a
curriculum model is developed and a curriculum starts to appear...
Known areas of study are simply placed adjacent to the appropriate concept areas and a
developing concept of a Health Science curriculum starts to emerge...
(while the relationships might be obvious... the details of interaction are not... and explaining
those detailed interactions is what education is all about, eh?)
When talking about health
one quickly realizes that all
things health relate to cell
function of one sort or
another...
Those things that maintain or enhance cell function can be considered to be “healthy”
Those things that compromise cell function can be considered to be “unhealthy”
Providing a convenient model for a general or introductory course in health
at any academic level
(but just not quite right yet for a curriculum...)
Because what follows is a model for a university-level Health-Science curriculum... The
individual course details quickly get very complex...
With a focus on cell functions... an introductory-level course in biology that includes some
biochemistry and cell biology is necessary as a starting point:
(And yes... the next slide is meant to be ridiculously complex)
In order to easily understand current concepts in the biological basis of human function and health, a
cellular approach is necessary; which means that the first course in a Health Science Curriculum will be an
Introduction To Metabolic Biochemistry And Cell Biology
Structure
Cell Structures
Functions
Metabolism /
Biochemistry
Protein Synthesis
Damage
Cell Division
Necrosis
Inflammation
Once a general model of cellular function has been established (including concepts of normal
function, dysfunction, and consequences of damage) other courses are then developed
and added to the curriculum:
Nutrients... Diet... Human Disease... Learning... Exercise... Sex... Drugs...
With a focus on:
Metabolic Biochemistry And Cell Biology
And
How Alterations in Cell Function Affect “Health”
(almost there with an overall curriculum concept...)
Concepts of Diet & Nutrition are added & the cellular model of “normal” function
becomes:
Inflammation
and concepts of damage and cellular dysfunction are discussed as nutritional
deficiencies with clinical health consequences (ie. deficiency diseases)...
Inflammation
The developing concept of Health is now seen as an interaction between factors that affect
cell function(s) and the response to cellular dysfunction & damage and how that
response is related to some forms of disease...
With the addition of this concept:
Health is considered to be the “end-result” of an
interaction between factors that affect cell functions &
the response to cellular dysfunction and damage &
how that response affects cell functions, organ function and
whole-body function...
It is a simple matter to add in concepts of human disease to that model...
(Naturally, every new course starts with a review of metabolic biochemistry
and cell biology with an additional emphasis on those functions
that are topical within the new course...)
By incorporating various aspects of Human Disease into the cellular-function model it becomes
evident that disease is a chemical or biochemical process that leads to cellular dysfunction
and/or damage and the cellular / organ / systemic response to that damage is the
manifestation (symptoms) of the disease
Human disease is nothing more than cellular function gone “awry” and mechanisms of disease are
really nothing more than those specific processes that affect cellular function...
Environmental Exposure:
estrogenic pesticides increase risk for breast cancer?
Heredity:
inheriting BRCA1 & BRCA2 genes increases risk for breast cancer?
Behaviors:
lack of physical activity increases risk for breast cancer?
Diet:
Red dye #3 in foods alters cellular mechanisms that lead to increased risk for
breast cancer?
Normal Aging:
normal cell division processes in ductal epithelial cells of the breast increases
risk for breast cancer over time?
Therefore the Conceptual Model of Health becomes:
Courses with a strong behavioral
component such as: Human
Sexuality and Drug Use and
Abuse start with the learning /
behavioral concepts developed
earlier in this presentation while
nerve-cell functions (and their
interactions on social, formal,
and informal learning)
appropriate to the specific
courses are incorporated as
appropriate...
Courses in Exercise Science
also are important because of
the almost universal beneficial
effects of exercise on cellular
metabolism and cell function
(think prevention here...)
And the Conceptual Model for a
Health Science Curriculum
becomes:
Each course starts with an overview of
cell functions & disease mechanisms
to re-orient everyone to the health
model...
Each course then emphasizes the
new functions and functional
relationships that are specific
to the course area... and
reviews relationships
with relevant functions
discussed in all previous
courses within the curriculum
Adding another course into the curriculum becomes relatively easy...
For example:
The Biological Basis of Prevention Through Diet & Exercise...
Mechanisms of metabolism
and regulation of protein
synthesis from previous
courses are reviewed and
then expanded on with
new details...
Various dietary
components and the
different effects
of exercise that
alter Mechanisms
Of Disease are
emphasized...
Resulting in a Detailed
analysis of Prevention...
and, obviously, (how)
Enhancement of Health
(works)
And the Conceptual
Model for the expanded
Health Science Curriculum
becomes:
When relating the resulting model of a health curriculum to other levels of
education: graduate school, high school, middle school, elementary school...
The ONLY difference is in the degree of detail and level of complexity required
Simply consider the individual courses in the university curriculum as chapters in a
book on health...
Developing an Integrated BBL Curriculum:
1. Comprehensive and detailed analysis of all areas (courses) of study...
2. Understanding of the details of inter-relationships among areas and variables within each area...
3. A Conceptual Framework for each course and for the entire curriculum (including appropriate
order... ie. prerequisite courses prior to advanced courses)...
4. Embed review of prior concepts into each course to enhance learning and overall conceptual
understanding...
5. Embed review of curriculum concepts into each course to enhance learning and overall
conceptual understanding...
6. Embed assessments into each course that forces review of previously covered material in
addition to covering new material...
Bibliography
Benjamin, S. "An Ideascope for Education: What Futurists Recommend." Educational Leadership 47/1 (1989): 8-16.
Bonds, C.; Cox, C., III; and Gantt-Bonds, L. "Curriculum Wholeness through Synergistic Teaching." The Clearing House 66/4 (1993): 252-254.
http://www.isbe.state.il.us/ils/science/pdf/descriptor_1-5.pdf
How People Learn: Brain, Mind, Experience, and School: Expanded Edition (2000) commission on Behavioral and Social Sciences and Education. Center for
Education (Division of Behavioral and Social Sciences and Education of the National Academies), National Academy Press
Caine, G. and R. N. Caine, and S. Cromwell. Mind shifts: A Brain-Based Process for Restructuring Schools and Renewing Education. Tucson, AZ: Zephyr Press, 1994.
Jensen, E. Teaching with the brain in mind. Alexandria, VA: Association for Supervision and Curriculum Development, 1998.
Jensen, E. Brain-Based Learning: The New Paradigm of Teaching. Thousand Oaks, CA, Corwin Press (A Sage Company), 2008.
Humphreys, A.; Post, T.; and Ellis, A. Interdisciplinary Methods: A Thematic Approach. Santa Monica, CA: Goodyear Publishing Company, 1981.
Fogarty, R. The Mindful School: How to Integrate the Curricula. Palatine, IL: Skylight Publishing, Inc., 1991.
Bonds, C.; Cox, C., III; and Gantt-Bonds, L. "Curriculum Wholeness through Synergistic Teaching." The Clearing House 66/4 (1993): 252-254.
http://www.smallschoolsproject.org/PDFS/Planning_Resources/summer2003/summer2003-integrating.pdf - (a truly excellent resource on IC)
Friend, H. The Effect of Science and Mathematics Integration on Selected Seventh Grade Students: Attitudes Toward and Achievement in Science. New York: New
York City Board of Education, 1984.
Berlin, D., and White, A. "Report from the NSF/SSMA Wingspread Conference: A Network for Integrated Science and Mathematics Teaching and Learning." School
Science and Mathematics 92/6 (1992): 340-343.
Malecki, C. "Teaching Whole Science in a Departmentalized Elementary Setting." Childhood Education 66/4 (1990): 232-237.
G Choon-Huat Koh, H Eng Khoo, M L Wong, and D Koh. The effects of problem-based learning during medical school on physician competency: a systematic
review, CMAJ: 178 (1) 2008.
Merrill, M.D. (2002). "A pebble-in-the-pond model for instructional design". Performance Improvement 41 (7): 39–44.
J D Martin,. Concept Mapping as an aid to lesson planning: A longitudinal study. Journal of Elementary Science Education, 6(2), 11-30., 1994.
B S Allen, R P Hoffman, J Kompella, T G Sticht . Computer-based mapping for curriculum development. In: Proceedings of selected Research and Development
Presentations Technology sponsored by the Research and Theory Division. New Orleans, LA, 1993.
M A Dyrud. Mapping: A Collaborative Activity for fun or profit. The Bulletin of the Association for Business Communication, 57(2), 57-58., 1994.
C D Ennis. Knowledge and beliefs underlying curricular expertise. Quest, 46, 164-175., 1994
Edmondson, K. M. (1995). Concept Mapping for the development of medical curricula. Journal of Research in Science Teaching, 32 (7), 777-793.
Novak, J. D. (1998). Learning, creating, and using knowledge: Concept Maps as facilitative tools in schools and corporations. Mahweh, NJ: Lawrence Erlbaum Associates.
http://informingscience.org/proceedings/InSITE2005/I42f49McDa.pdf
How People Learn: Brain, Mind, Experience, and School: Expanded Edition. Commission on Behavioral and Social Sciences and Education. Center for Education
(Division of Behavioral and Social Sciences and Education of the National Academies), National Academy Press, 2000.
Raffaella Molteni, Zhe Ying, Fernando Gómez-Pinilla (2002) Differential effects of acute and chronic exercise on plasticity-related genes in the rat hippocampus revealed by
microarray. European Journal of Neuroscience 16 (6), 1107–1116.